Provider Demographics
NPI:1790230639
Name:MCDOWELL, HEATHER (FNP-C)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 E HOME RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-2725
Mailing Address - Country:US
Mailing Address - Phone:937-342-1619
Mailing Address - Fax:937-390-7148
Practice Address - Street 1:1117 E HOME RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-2725
Practice Address - Country:US
Practice Address - Phone:937-342-1619
Practice Address - Fax:937-390-7148
Is Sole Proprietor?:No
Enumeration Date:2016-08-21
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.18870363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner